The molecular characteristics of congenital muscular torticollis patients living in Qinghai-Tibetan Plateau
Abstract
Background: Congenital Muscular Torticollis (CMT) is defined as interstitial fibrosis and contracture of one side of the sternocleidomastoid muscle (SCM), typically resulting in the head and neck deviating to the affected side, the lower jaw turning to the opposite side, and limitation of the rotation of the head and neck. As China’s largest and highest region, the Qinghai-Tibetan Plateau (QTP) is recognized as one of the world’s critical biodiversity hotspots. Methods: The blood and SCM bio-samples from 20 patients and their parents at Qinghai Women and Children’s Hospital were collected. The clinical properties of these individuals, including gender, ethnic group, and age at initial diagnosis, were analyzed. Whole exon sequencing was then performed on the blood and SCM bio-samples to characterize the molecular properties of CMT patients living in the Qinghai-Tibetan Plateau (QTP) region. Results: The female to male ratio was 9:11 for these 20 patients, the age varied from 1 to 13 years old, 17 of them showed SCM fibrosis, and 18 of them were found CMT symptoms when they were born. The number of single nucleotide polymorphisms (SNP) varied a lot for across different chromosome and lots of them were located in chromosome 1 and 2. The variation of C→T and G→A were the most common alteration types, and patients have no significant differences in various ethnic groups. The comparison of molecular variations in family members suggested the genetic variations for CMT, which could provide targets in treatment of CMT. Conclusions: The findings indicated that glucose and lipid metabolism, as well as antigen processing, might be involved in the development of CMT. This could increase the efficacy of diagnosis and prognosis, ultimately leading to the development of optimal targeted therapeutics for CMP patients living in QPT.
References
1. Wei JL, Schwartz KM, Weaver AL, Orvidas LJ. Pseudotumor of infancy and congenital muscular torticollis: 170 cases. Laryngoscope. 2001; 111(4 Pt 1): 688–695.
2. Kuo AA, Tritasavit S, Graham JM. Congenital muscular torticollis and positional plagiocephaly. Pediatr Rev. 2014; 35(2): 79–87.
3. Płomiński J, Olesińska J, Kamelska-Sadowska AM, et al. Congenital muscular torticollis-current understanding and perinatal risk factors: a retrospective analysis. Healthcare (Basel). 2023; 12(1): 13.
4. Parau D, Todoran AB, Balasa R. Factors Influencing the Duration of Rehabilitation in Infants with Torticollis-A Pilot Study. Medicina (Kaunas). 2024; 60(1): 165.
5. Guo S, Zheng Y, Zhang Z, Qian C, Fu D, Li H, Liu Y, Wu H, Ju H, Yu X, Wang D, Song J. Factors associated with postoperative muscle reconnection in children's congenital muscular torticollis. Transl Pediatr. 2023; 12(9): 1707-1714.
6. Scaal M, Christ B. Formation and differentiation of the avian dermomyotome. Anatomy and Embryology. 2004; 208(6): 411–424.
7. Sheeba CJ, Andrade RP, Palmeirim I. Mechanisms of vertebrate embryo segmentation: Commonthemes in trunk and limb development. Semin. Cell Dev. Biol. 2016, 49(1): 125–134.
8. Raucci U, Roversi M, Ferretti A, et al. Pediatric torticollis: clinical report and predictors of urgency of 1409 cases. Ital. J. Pediatr. 2024; 50(1): 86.
9. Gundrathi J, Cunha B, Mendez MD. Congenital Torticollis. In: StatPearls [Internet]; StatPearls Publishing; 2024.
10. Jakovljevic M, Chang H, Pan J, et al. Successes and challenges of China’s health care reform: a four-decade perspective spanning 1985–2023. Cost Eff Resour Alloc. 2023, 21(1): 59.
11. Xing YW, Richard HR. Uplift-driven diversification in the Hengduan Mountains, a temperate biodiversity hotspot. Proc. Natl. Acad. Sci. USA 2017; 114: E3444-E3451.
12. Li D, Jiang X, Gong W, Li C. Tectonic uplift along the northeastern margin of the Qinghai–Tibetan Plateau: Constraints from the lithofacies sequence and deposition rate of the Qaidam Basin. Tectonophysics. 2022; 827: 229279.
13. Li H, Durbin R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics. 2009; 25: 1754–1760.
14. Li H, Handsaker B, Wysoker A, et al. 1000 Genome Project Data Processing Subgroup. The Sequence alignment/map (SAM) format and SAMtools. Bioinformatics. 2009; 25: 2078–2079.
15. Quinlan AR, Hall IM. BEDTools: A flexible suite of utilities for comparing genomic features. Bioinformatics. 2010; 26(6): 841–842.
16. McKenna A, Hanna M, Banks E, et al. The Genome Analysis Toolkit: A MapReduce framework for analyzing nextgeneration DNA sequencing data. Genome Research. 2010; 20: 1297–1303.
17. Wang K, Li M, Hakonarson, H. ANNOVAR: Functional annotation of genetic variants from high-throughput sequencing data. Nucleic Acids Research. 2010; 38: e164-e164.
18. Sayers EW, Beck J, Bolton EE, et al. Database resources of the National Center for Biotechnology Information. Nucleic Acids Res. 2018; 46(D1): D8-D13.
19. Hou YN, Gao B, Li GJ, Su ZC. MaxMIF: A New Method for Identifying Cancer Driver Genes through Effective Data Integration. Adv. Sci. 2018; 5: 1800640.
20. Cho A, Shim JE, Kim E, et al. MUFFINN: Cancer gene discovery via network analysis of somatic mutation data. Genome Biol. 2016; 17: 129.
21. Lawrence MS, Stojanov P, Mermel CH, et al. Discovery and saturation analysis of cancer genes across 21 tumour types. Nature. 2014; 505(7484): 495–501.
22. Lawrence MS, Stojanov P, Polak P, et al. Mutational heterogeneity in cancer and the search for new cancer-associated genes. Nature. 2013; 499(7457): 214–218.
23. Kim CY, Baek S, Cha J, et al. HumanNet v3: An improved database of human gene networks for disease research. Nucleic Acids Res. 2022; 50(D1): D632–D639.
24. Zhao Z, Deng H, Li Y, et al. Futang Research Center of Pediatric Development (FRCPD). Experience with the management of 2599 cases of congenital muscular torticollis and a multicenter epidemiological investigation in 17 hospitals in China. BMC Musculoskelet Disord. 2023; 24(1): 901.
25. Do TT. Congenital muscular torticollis: current concepts and review of treatment. Curr. Opin. Pediatr. 2006; 18(1): 26–29.
Copyright (c) 2025 Author(s)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright on all articles published in this journal is retained by the author(s), while the author(s) grant the publisher as the original publisher to publish the article.
Articles published in this journal are licensed under a Creative Commons Attribution 4.0 International, which means they can be shared, adapted and distributed provided that the original published version is cited.